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HomeMy WebLinkAboutX2021-2861 - Permit ApplicationPrint f=orm Worksheet for Combo Building & Solar Permiii AAppliation g Comm'( r Residential ing NOTE: PILAN HECKty of OF E S DUE each - AT TIME OF (SUBMITTAL ��_ ��' uc.'oa�•'� 7$uilding r Grading ( Drainage lec Mech Plum cuvdCut F Cu Yd Fill F Project Addresjs (Not mailing address) F_ Flood 7` Fire (" Liq f– Landslide [N/A Floor Suite No I _�( Il1�1�1��✓ - F F Description of Work Use 11 1 . Const Type F7- -72 # Stories # Units (if Res)r4 I Valuation �Z Material/Labor ,— � New/Add SF Remodel SFl �L�I'� Garage/New/Add � OWNER'S NAME Last First d Owner's Address Owner's E-mail Address City State r----_. Zip F_. Telephoned APPLICANT'S NAME Last (M First Gly p Applicant's Address Applicants E-mail Address ddress �r00 e a—TJl`*-'t 'P6A ty �e�,pC,/_taq �(� City c_ / �tLI� �y /_�✓l State Zip�Telephosn�O �/' h-1.��✓.. ARCHITECT/D SIGNER'S NAME Last /G� First Lic. No. C l Z2j ®l'YrC�e[5 � �nitGaG - 8 Architect/Designer's Address Architect/Designer's E-mail Address City I State I-_-_, Zip f—, Telephoner— ENGINEER'S NAME Last KA First F_ Lic. No.F— Engineer's Address Engineer's E-mail Andress City State F__ Zip Telephoned CONTRACTOR'S NAME/COMPANY LiNo.PVi 5-C���, [' Contractor's Address Contractor's E-mail Address 738 I-(st� Lr� �v5ccy�l City *'`�- a State I cF'� Zip - Telephone ["r1 •95"4806 SETBACKS REAR . SETBACKS FRONT PERMIT NO. 1 2 CQ SETBACKS LEFT SETBACKS RIGHT PLAN CHECK NO. 7/ I USE ZONE DEVELOPMENT NO PLAN CHECK FEES $